文章摘要
模拟肠镜进镜置管法在左半溃疡性结肠炎中药保留灌肠中的疗效观察
Observation on the curative effect of simulated enteroscopy in the treatment of left ulcerative colitis with traditional Chinese medicine retention enema
投稿时间:2023-09-05  修订日期:2023-09-05
DOI:
中文关键词: 溃疡性结肠炎  模拟肠镜进镜置管法  中药保留灌肠  临床疗效
英文关键词: Ulcerative colitis  simulated colonoscopy catheterization  traditional Chinese medicine retention enema  clinical effect
基金项目:浙江中医药科技计划项目模拟肠镜进镜置管法在左半溃疡性结肠炎中药保留灌肠中的疗效观察,编号:2021ZA078
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中文摘要:
      【】目的:探究模拟肠镜进镜置管法在左半溃疡性结肠炎中药保留灌肠中的疗效及安全性。方法:筛选于2020年9月至2023年2月治于我院的左半溃疡性结肠炎患者共100例,随机分为试验组(n=50)和对照组(n=50)。所有患者均接受传统保留灌肠治疗,试验组患者在此基础上实施模拟肠镜进镜置管法保留灌肠。记录灌肠治疗后第一次排便的时间及舒适度评分,观察保留灌肠过程中两组患者的主诉以及不良反应,监测Mayo活动性评分及血清D-二聚体(D-D)、血小板(PLT)、白细胞介素6(IL-6)水平变化,对比两组患者的临床疗效。结果:试验组患者临床总有效率显著提高 (94.00% vs 80.00%,P <0.05);试验组患者平均灌肠液保留时间、舒适度评分等级均显著高于对照组患者(P <0.05);治疗后两组患者平均排便次数评分、便血情况评分、内镜下情况评分、医生评估评分及Mayo评分较治疗前均显著降低,且试验组患者各Mayo活动性评分降低更明显(P<0.05);治疗后两组患者PLT、血清D-D及IL-6水平均显著降低,且试验组患者各实验室检验指标水平降低更明显(P<0.05);试验组患者治疗期间及住院期间总不良事件发生率较低,但组间差异无统计学意义(10.00% vs 18.00%,P >0.05)。结论:顺应于直肠解剖生理特点的模拟肠镜进镜置管法联合中药保留灌肠对于左半溃疡性结肠炎患者具有更显著的临床疗效,可减少导管对肠壁的刺激和损伤,延长灌肠液在肠道内的保留时间并提高患者的舒适度。
英文摘要:
      Objective  To explore the efficacy and safety of simulated enteroscopy in the treatment of left ulcerative colitis with traditional Chinese medicine retention enema. Methods  100 patients with left ulcerative colitis treated in our hospital from September 2020 to February  2023 were randomly divided into experimental group (n=50) and control group (n=50). All patients received traditional retention enema, on the basis of which the patients in the experimental group were treated with retention enema by simulated colonoscopy. The time and comfort score of the first defecation after enema were recorded. The chief complaints and adverse reactions of the two groups during retention enema were observed. The activity score of Mayo and the levels of serum D-dimer (Dmurd), platelet (PLT) and interleukin-6 (IL-6) were monitored. The clinical effects of the two groups were compared. Results  The total clinical effective rate of the patients in the test group was significantly higher than that in the control group (94.00% vs 80.00%, (P <0.05). The average retention time of enema and the score of comfort in the test group were significantly higher than the control group (P <0.05). After treatment, the average defecation frequency score, hematochezia score, endoscopic score, doctor evaluation score and Mayo score in the two groups were significantly lower than before treatment, and the Mayo activity scores in the experimental group decreased more significantly (P <0.05). After treatment, the levels of PLT, serum Dmure D and IL-6 in the two groups decreased significantly after treatment, and the laboratory indexes in the experimental group decreased more significantly (P <0.05). The total incidence of adverse events during treatment and hospitalization in the experimental group was low, but there was no significant difference between the two groups (10.00% vs 18.00% P > 0.05). Conclusion  Simulated endoscopic catheterization combined with traditional Chinese medicine retention enema, which conforms to the anatomical and physiological characteristics of rectum, has a more significant clinical effect on patients with left ulcerative colitis and can reduce the irritation and injury of catheter to intestinal wall. prolong the retention time of enema fluid in the intestine and improve the comfort of patients.
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